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<br />Ciry of <br />.SIMbbE <br /> <br />Minnesota <br /> <br />",' -;,,"l' l~t~ .,)t:<.f <br />\ <br /> <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 Phone: 651-490-2279 Fax: 651-490-2931 <br />E-mail: dennis.welsch~ci.roseville.mn.us <br />(City Code, Zoning Map and Comprehensive Plan Map are available on the Internet at: <br />www.ci.roseville.mn.us) <br /> <br />PF# <br />Please check item or items for which you a <br /> <br />L PUD - Comprehensive Plan Amendment$i50 <br />Rezoning of Site Conditional Use Permit $200 <br />Zoning Text Amendment Minor Subdivision $100 <br />Vacation of Right-of-Way Relocation of Dwelling $100 <br />Vacation of Easement Variance to Zoning Ordinance $200 <br />_ Preliminary & Final Plat $500 _ Interim Use Permit $200 <br />4 fI1ailing Lab~ls $35.00 + $.25/label <br />..,.~\. .-.-..,' b\<: . <br />When applying for more than one approval, only one fee (the"highest) is charged. Please complete this <br />form by typing or printing in ink, If the spaces provided are insufficient, use additional sheets and refer the <br />information to the proper page and item number. All applicable items must be completed and all required <br />information attached for the application to be accepted as complete. In order to be considered by the <br />Planning Commission and City Council, the applicant must be present at the meetings. <br /> <br /> <br />1. <br /> <br />~i\ c ~\ S f(\ 0-. L; .'vi \ 4-<"{' o/.~ i\Q W 1\ ~ JJ LL I::> <br />Name of Owner: (First) (Middle) (Last) <br /> <br />6,Q~~ Sov-\'~ c;~ S\'~E-:i MSP I IY\N S'SLfO~ <br />Address of Owner: (No. And Street) (City) . (St1te).; (Zip) <br />~0 'S.C~~I'h ~ <br />- T 1'1' ~0 c <c. Id S~' I r:s=-/f.. I.c: <br />(Phone I (Fax) , , <br /><c I.J (f5 i ~'/I '1 <br />d.IO l.'v' 0,-1) ShrttLc ?EE Rc,,1i vIr\; <(;Sl./3 ') <br />Address of Applicant (No. And Street) (City) (St te) (Zip) <br /> <br />;;}79~ - rl8 s3 tt;D~t~ ~Ht~l~ Itlt'Y\V-E- RC$J.~l:'.lb , I~I~) <br />Street Address of Property Involved: I <br /> <br /> <br />2. <br /> <br />3. <br /> <br /> <br />4. <br /> <br />5. <br /> <br />6. <br /> <br />Complete Legal Description & Pin Number of Property Involved (may attach): <br />See A+frIcJ(J} Pit\) +f (;"2> a(/ J~;:) fO(i ').70 <br /> <br />7. <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br /> <br />Page 1 of 5 <br /> <br />. C\~ 00 <br />